易水学派汗证辨治思路探微*
作者：王欣仪1，熊益亮1,2
单位：1.北京中医药大学国学院，北京 102488； 2.北京中医药大学易学与儒释道医学研究所，北京 102488
引用：引用：王欣仪，熊益亮.易水学派汗证辨治思路探微[J].中医药导报,2025,31(11):240-244.
DOI：10.13862/j.cn43-1446/r.2025.11.044
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摘要：易水学派对于汗证的辨治思路在汗证治疗史上承前启后，颇具特色。对易水学派在汗证辨治中的病因病机、辨证论治以及辨治方法进行整理与分析，以期为汗证研究及易水学派学术思想研究提供借鉴。易水学派认为，汗证的主要发病机制为脾胃气虚、内伤湿热，或脾肾阳虚、内生寒湿，从而导致汗出异常。其在辨证论治汗证时，多补脾益肺，固表止汗，治表虚自汗；补中益气，升阳散火，治虚热自汗；运脾胜湿，升阳开泄，治湿胜自汗；清热除火，滋阴补脾，治阴虚盗汗；升清健脾，清利湿热，治下焦阴汗；温补脾肾，助阳退阴，治里虚冷汗。在具体辨治时，常以脏腑辨治或气血津液辨治等方法综合运用治疗汗证。
关键词：汗证；易水学派；病因病机；辨证论治
Abstract：
The Yishui School's thought on syndrome differentiation and treatment of sweat syndrome serves as a connecting link between the past and the future in the history of sweat syndrome treatment, featuring distinctive characteristics. This paper sorts out and analyzes the etiology, pathogenesis, syndrome differentiation and treatment, and therapeutic methods for sweat syndrome in the Yishui School, aiming to provide reference for the research on sweat syndrome and the academic thoughts of the Yishui School. According to the Yishui School, the primary pathological mechanisms of sweating syndrome inducing spleen-stomach Qi deficiency, internal damp-heat, or spleen-kidney Yang deficiency with internal cold-dampness, which ultimately leads to abnormal sweating. In the syndrome differentiation and treatment of sweat syndrome, the school mainly adopts the following methods: tonifying the spleen and benefiting the lung, consolidating the exterior to stop sweating for exterior deficiency spontaneous sweating; tonifying middle Qi, lifting Yang and dispersing fire for deficient heat spontaneous sweating; transporting the spleen to overcome dampness, lifting Yang and inducing dispersion for dampness excess spontaneous sweating; clearing heat and reducing fire, nourishing Yin and tonifying the spleen for Yin deficiency night sweating; lifting lucidity and invigorating the spleen, clearing and draining damp-heat for lower jiao Yin sweating; warming and tonifying the spleen and kidney, assisting Yang to dispel Yin for interior deficiency cold sweating. In specific clinical practice, methods such as zang-fu organ syndrome differentiation or Qi-blood-body fluid syndrome differentiation are often comprehensively applied in the treatment of sweat syndrome.
Key words：sweat syndrome; Yishui School; etiology and pathogenesis; syndrome differentiation
发布时间：2025-11-30
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